JULIA REGINA PESAVENTO Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

ACTIVE

Business

First Name

JULIA REGINA

Last Name

PESAVENTO

Business Name

JULIA REGINA PESAVENTO

Original Issue Date

08/19/1985

Effective Date

05/08/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/08/2024